Supervisory team
LSHTM
- Oona Campbell (lead supervisor)- [email protected]
- Zeina Jamaluddine (third supervisor) - [email protected]
Nagasaki University
- Lina Madaniyazi (second supervisor) - [email protected]
The project
The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has helped Palestinian refugees since 1950 in five countries/territories: Jordan, Lebanon, Syria, West Bank and Gaza, with Headquarters (HQ) in Jordan. UNRWA services include comprehensive healthcare, education, social services, camp infrastructure and improvement, and emergency assistance. In recent years, and with Japanese funding, UNRWA has invested substantially in an electronic data-infrastructure, generating several years’ worth of electronic data that can be linkable through unique identifiers. The total UNRWA population of eligible beneficiaries is nearly 6 million refugees. This yields enormous statistical power to look at the individual and clustered data (144 health centres, 708 schools, 62+ geographic locations (camps/ multiple informal gatherings) and 5 countries/territories).
These unique data have features rarely found in other longitudinal population studies or Health and Demographic Surveillance Sites (HDSS) in LMICs:
- A large mainly urban-slum dwelling population. With exceptions (e.g. Brazil’s 100-million cohort), large longitudinal population studies and HDSS are generally rural.
- Geographical dispersion in 62+ camps/ gatherings within/across 5 countries/territories, seeking services in 144 health centres and 708 schools. These variations in geographies and facilities permit clustered analyses.
- Settings that have undergone epidemiologic transition, with substantial non-communicable disease (NCD), mental ill-health and injury-associated burdens
- A first for the Arab region, which currently has no HDSS or sizeable longitudinal population studies.
UNRWA records include:
- maternal health records (since 2010) on preconception care, antenatal care visit data (parity, blood pressure, …), place of birth, pregnancy outcomes (stillbirth and preterm birth, delivery care, post-natal care.
- child health records (since 2013) including immunization and growth monitoring
We (ZJ and OC) used a previous Nagasaki WISE PHD to build the first birth cohort of protracted refugees and link maternal and child health records. These data can also be overlaid with data on temperature and humidity ok at the effects of these exposures on adverse health outcomes.
Critically, these health data can be linked with climate and environmental datasets, including temperature, humidity, drought indices, and water availability, to assess the impact of climate-related risks on adverse health outcomes.1-4 Refugees, particularly those living in overcrowded urban camps with limited water infrastructure, are acutely vulnerable to heatwaves, water insecurity, and climate-exacerbated disease burdens.
The candidate may choose to focus on one or more climate-related risk factors, such as extreme heat, drought, or water insecurity, or propose an alternative exposure relevant to the refugee context. The selected exposure(s) will be linked to health outcomes using environmental data and UNRWA’s longitudinal health records, enabling robust epidemiological analysis.
We have a provisional agreement with UNRWA to use the data.
- Wang, P., Rogne, T., Warren, J. L., Asare, E. O., Akum, R. A., Toure, N. D. E., ... & Chen, K. (2025). Long-term drought and risk of infant mortality in Africa: A cross-sectional study. PLoS medicine, 22(1), e1004516.
- Seposo, X., Celis-Seposo, A. K., Uttajug, A., Tajudin, M. A. B. A., & Ueda, K. (2025). Impact of prenatal drought exposures on under-5 childhood stunting in 32 low-and-middle-income countries: a global analysis using demographic and health survey. Environmental Health, 24(1), 61.
- Hajat, S., Gampe, D., Sarsour, A., & Abuzerr, S. (2022). Climate change and diarrhoeal disease burdens in the Gaza Strip, Palestine: health impacts of 1.5 C and 2 C global warming scenarios. International Journal of Environmental Research and Public Health, 19(8), 4898.
- Lakhoo DP, Brink N, Radebe L, Craig MH, Pham MD, Haghighi MM, Wise A, Solarin I, Luchters S, Maimela G, Chersich MF. A systematic review and meta-analysis of heat exposure impacts on maternal, fetal and neonatal health. Nature Medicine. 2025 Feb;31(2):684-94.
The role of LSHTM and NU in this collaborative project
We will conduct conversations to explore mutual interests and to focus the research question of interest in alignment with the mutual interests of the LSHTM and Nagasaki researchers, and UNRWA.
Lina Madaniyazi, the Nagasaki supervisor has skills in assessing the impact of climate related risk on health.
This complements Oona Campbell’s knowledge of epidemiologic methods and maternal and child health issues and will build both organizations’ capacities in the areas of health systems for vulnerable populations and to improve MNCH. Zeina Jamaluddine built the cohort as part of her PhD, and has extensive knowledge of the data and of overlaying them with ecological exposures such as conflict. At LSHTM we hope to learn from Japan’s traditions of supporting good health management information systems data in LMICs.
If successful, we will work to meet face-to-face, share responsibilities ensuring the student develops a good protocol, and meet regularly via zoom. The student will spend time in the Japan and in the UK, as well as in the Middle East region and the relevant stages of planning, conducting the study, and writing up results. With agreement, it may be possible to host the student at UNRWA offices in Jordan.
Particular prior educational requirements for a student undertaking this project
- Master’s degree in relevant public health (epidemiology or statistics)
- Strong analytical, quantitative research skills; experience analysing quantitative data
- Knowledge of Stata and/or R software
- Proven excellent interpersonal, and organizational skills
- Fluent in spoken and written English and ideally in ArabicDemonstrated experience in working with refugees (highly desirable)
Knowledge of the Middle East countries where UNRWA works.
Skills we expect a student to develop/acquire whilst pursuing this project
By pursuing this study, the student will:
- Develop skills to manage big data and link multiple electronic records
- Develop approaches to assess data quality
- Learn techniques to manage missing data (e.g. multiple imputation)
- Learn to analyse longitudinal data from a cohort including survival analysis, with time varying covariates,
- Learn about substantive issues in the field of climate maternal, newborn, and child.
- Develop paper-writing and presentation skills